GAPS IN COMPETENCE OF INTEGRATED SERVICE POST CADRES AND HEALTH WORKERS IN MEASURING BODY LENGTH AND STUNTING STATUS OF CHILDREN UNDER TWO YEARS OLD IN CENTRAL JAVA, INDONESIA

Abstract

Integrated service post cadres in Indonesia carry out early detection of stunting in the community. They are volunteers and not all of them are specially trained in anthropometric measurements. Hence, the results of stunting measurement by cadres may be inaccurate. This study analyzed differences in accuracy of body length and stunting status measured by integrated service post cadres and health workers. This study was an observational study using a cross-sectional design. The study was conducted in Demak Regency with 452 cadres from 94 integrated service posts in 20 villages that were selected purposively. Each cadre measured the body length of 10 children under two years old, compared to that of the health workers as a reference group. Measured children were randomly selected. Stunting status was calculated from the percentage of children with a length-for-age Z-score (LAZ) smaller than –2 standard deviation (SD). Data were analyzed by Wilcoxon signed rank test and Chi-square test. The cadres performed body length measurements less accurately than health workers. Stunting status in children under two years old was measured less accurately by cadres (3.5% difference) than by health workers (16.1% versus 19.6%). There was a significant difference in the accuracy of child body length and stunting status of children under two years old measured by the cadres and health workers (p<0.001). In summary, the ability of cadres to measure children’s body length was weaker than that of health workers, and the poor competence in measuring may potentially cause misclassification of stunting status.